Quality Improvement Program Evaluator

AHCCCS

Arizona Health Care Cost Containment System

Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.
AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.
Come join our dynamic and dedicated team.

Quality Improvement Program Evaluator

Division of Managed Care Services (DMCS)

Job Location:

Address: 801 E. Jefferson Street, Phoenix, AZ 85034

Posting Details:

Salary: $65,000 - $70,000 

Grade: 22

Open Until Filled

This position is grant funded. Employment is contingent upon availability of the grant funds.

Job Summary:

This position will function as a member of the Strategic Performance/Quality Improvement (QI) team within the Division of Managed Care Services (DMCS) and support the AHCCCS Housing team within the Division of Behavioral Health and Housing (DBHH).

This position will be responsible for developing population and program-specific quality metrics to inform monitoring and performance improvement activity recommendations based on data analyses and data validation activities for the QI team and Housing team. These activities will include evaluation and analysis of annual performance measure data, member satisfaction surveys, data specific to performance improvement projects, housing-related outcomes, and other quality data to support project activities, as well as conducting data analysis to identify opportunities for improvement to guide each team’s strategic priorities. This position will also support data validation efforts for several team projects, including review of both internal and external data to identify potential issues for correction. This position will work with internal and external program stakeholders as needed to support housing and QI data project requirements. This position will be required to have an understanding of the Housing and Health Opportunities (H2O) program evaluation and demonstration requirements, develop and/or refine program evaluation and demonstration metrics as needed to improve the program’s quality structure, and implement processes to collect and receive Key Performance Indicator data, outcome metrics, and source reports. This position will analyze H2O program data and reporting, assess for trends, identify opportunities for program improvement, and evaluate program effectiveness. This position will lead waiver discussions related to H2O program evaluation and outcomes. Additionally, this position will be cross-trained on general aspects of AHCCCS quality improvement to support other team activities as needs are identified.

This position is responsible for understanding the needs of the populations served by AHCCCS, including those served by AHCCCS housing programs and the H2O program, and the objectives of stakeholders, as well as contributing to the effectiveness of multiple teams within the DMCS and DBHH. This position requires an understanding and application of quality improvement best practices, concepts, and techniques, data analysis and interpretation skills, data validation skills, attention to detail, and strong communication capabilities. The selected candidate will be required to prepare content for and participate in internal and external stakeholder work groups, prepare formal project and program related reports, and must be comfortable working with cross-functional teams.

Major duties and responsibilities include but are not limited to:
• Facilitate the monitoring and evaluation of the Housing and Health Opportunities (H2O) program through coordinating project activities with the program vendors contracted to assess the effectiveness of the program. Design/redesign elements of the program’s quality structure, including refinement of program metrics, based on data analysis findings. Implement and oversee data-sharing mechanisms to ensure collection of program data from multiple stakeholders (e.g., vendors, providers). Lead technical assistance efforts for internal and external H2O program stakeholders to enhance monitoring and evaluation activities and ensure alignment with measure technical specifications. Analyze program-related data to identify and report potential data issues to appropriate stakeholders and to ensure validity and accuracy of final reported data.
• Develop population and program-specific quality metrics to inform monitoring and performance improvement activity recommendations based on data analysis findings to drive strategic priorities for the QI and Housing teams. Support the QI and Housing teams with data analyses and data validation activities related to projects including but not limited to performance measures, member satisfaction surveys, performance improvement projects, housing-related outcomes, and federal waiver requirements. Summarize data analysis results for internal, including Division and Agency leadership, and external stakeholders to highlight successes and opportunities for improvement.
• Conduct data validation activities to ensure the accuracy of both internal and external project and program-related data. Ensure alignment with measurement methodologies and requirements using available information (e.g., project-related data instructions, publicly available specifications) and identify and document potential issues for correction. Lead efforts to change program or project metrics and data validation process improvements.
• Analyze H2O program data collected from vendors and providers as needed, along with any related internal or external data available, to evaluate program effectiveness regularly. Facilitate program reporting to ensure adherence to federal and state reporting requirements. Develop and/or refine program evaluation and demonstration metrics as needed to improve the program’s quality structure.
• Participate in Agency committees, work groups, subgroups, and H2O program meetings as appropriate. Develop content for and present information related to assigned projects as requested. Lead and/or participate in group discussions related to all topics of responsibility.

Knowledge, Skills & Abilities (KSAs):

Knowledge:
• Advanced knowledge of current QI tools, techniques, and concepts
• In-depth knowledge of and experience with quality measurement and/or performance measures, including National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) measures, Consumer Assessment of Health Plan Satisfaction (CAHPS) surveys, as well as measures developed by the Centers for Medicare and Medicaid Services (CMS), ADvancing States, HSRI, and other measure/survey stewards
• Data analysis, statistical analysis, and data validation methods
• Housing First and other evidence-based practices related to development, financing, and programming related to housing and services for special need or vulnerable populations (e.g., persons with disabilities, persons experiencing homelessness, persons with behavioral health diagnoses)
• Medicaid systems of care and supportive services reimbursement
• Private and public sector housing and program funding and finance practices including federal, state, local, and private sector grants or programs
• Research methods, including methodology development, sampling techniques, and methods to identify variation in clinical performance data
• Data Warehouse or claims & encounter data elements
• AHCCCS contract and policy requirements as well as Medicaid Managed Care regulations
• Health care delivery systems, programs, and principles, especially integrated care models
• Basic knowledge of medical terminology and healthcare practices

Skills:
• Data management, analysis, and reporting, including the analysis of large data sets and interpretation of results/findings
• Intermediate mathematical skills, statistical analysis, and research
• Advanced Microsoft Office and Google Suite skills (all programs)
• Strong interpersonal skills, including professionalism, as well as effective written and oral communication skills, especially communication involving statistics and quality data
• Organizational skills and attention to details that result in effective project management, prioritization of multiple tasks, and meeting deadlines in a fast-paced environment
• Strong critical thinking, decision making, and problem solving skills
• Intermediate technical, formal report writing, and presentation development skills

Abilities:
• Collaborate with others and and maintain effective professional relationships with internal and external stakeholders
• Work independently to make project and program decisions
• Prioritize multiple projects to meet goals and deadlines
• Manage time efficiently
• Actively participate in internal and external stakeholder work groups
• Analyze problems and develop effective and innovative solutions
• Produce high quality work with limited supervision
• Continuously learn and adapt to changes in best practices, requirements, regulations, and methodologies
• Work in a virtual office setting

Qualifications:

Minimum:
• Four years professional experience related to health programs appropriate to the assignment, which included program planning or administration; a Master's degree in a field appropriate to the assignment may substitute for one year of the required experience.

Preferred:
• Knowledge of public housing programs and associated program evaluation mechanisms.
• Experience with Cognos, Tableau, Microsoft Power BI, or similar data analytics platforms.
• At least one year of experience working in a Managed Care environment.
• Knowledge of state and federal policies, procedures, and regulations governing Medicaid programs and populations.

Pre-Employment Requirements:

• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.

• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.

• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits:

Among the many benefits of a career with the State of Arizona, there are:
• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

Lifetime Pension Benefit Program
• Administered through the Arizona State Retirement System (ASRS)
• Defined benefit plan that provides for life-long income upon retirement.
• Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
• Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).

Deferred Retirement Compensation Program
• Voluntary participation.
• Program administered through Nationwide.
• Tax-deferred retirement investments through payroll deductions.

Contact Us:

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.

Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

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